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Complications of Continuous Ambulatory Peritoneal Dialysis

Findings on MR Peritoneography

¹ Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Wien, Austria.
² Department of Nephrology, University of Vienna, A-1090 Wien, Austria.

OBJECTIVE. The purpose of this study was to assess the diagnostic value of MR peritoneography in complications of continuous ambulatory peritoneal dialysis.

SUBJECTS AND METHODS. Twenty consecutive patients treated with continuous ambulatory peritoneal dialysis who were clinically suspected of dialysis-related complications were prospectively studied with MR peritoneography. For MR peritoneography, 20 ml of gadodiamide was added to 2000-ml dialysate solution (1.36% glucose) that was instilled into the peritoneal cavity. MR peritoneography was performed with the peritoneal cavity filled (n = 12) and after complete drainage of the contrast material-dialysate mixture (n = 20) on a 1.5-T MR unit with a phased array coil. Imaging included axial T1-weighted fast low-angle shot (TR/TE, 174/4.2) with and without fat saturation and axial and coronal T2-weighted fat-saturated turbo spin-echo (3000/138) sequences. All studies were performed without IV contrast material. Images were reviewed for evidence of peritoneal leaks, hernias, loculated fluid collections, and adhesions.

RESULTS. Abnormal findings were detected in 13 (65%) of 20 patients and included retroperitoneal leaks (n = 6), diaphragmatic leaks (n = 2), catheter exit-site leaks (n = 2), inguinal hernias (n = 2), and peritoneal adhesions (n = 1).

CONCLUSION. MR peritoneography is useful for the evaluation of complications related to continuous ambulatory peritoneal dialysis, and it offers excellent tissue contrast and multiplanar imaging for assessment of complications.

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